Gottfried: Health Care Providers & Programs Shouldn’t Have to Choose between Keeping Government Funding or Restricting Info to Patients about Health Care

New York State set aside $16 million in its budget in March for health care providers who might lose federal funding because of the Trump administration’s “gag rule” about abortion and reproductive health services. Now that the gag rule has taken effect, New York State Assembly Health Committee Chair Richard N. Gottfried is calling on the Cuomo Administration to release that money immediately and make it available to health care providers.

The gag rule issued in March by the Trump administration bars family planning providers using federal funds (known as Title X funds) from offering patients information about birth control, abortion or even simply referring them to other health care programs that provide abortion. Although three federal district courts issued temporary injunctions staying the gag rule on the grounds that it could endanger health care for millions of patients around the country, a federal appeals court ruling lifted injunctions and the gag rule is now in effect. “To continue to provide proper professional health care,” said Gottfried, “health care providers have to lose their Title X funding.”

In anticipation of the gag rule, Assembly Member Gottfried and other legislators worked with Governor Cuomo’s administration to included money in the 2019 NYS budget legislation authorizing $16 million in State funds to support family planning providers in the event of lost federal Title X funding.

“Family planning providers understand that patient health comes first,” said Assembly Member Gottfried. “New York prepared for the threat from the Trump administration and must keep its commitment and release the funding necessary to fill the Title X gap.”

Title X funding was established in 1970 to provide affordable birth control and reproductive health care to low-income people who otherwise could not afford the health care.

Following is Assembly Member Gottfried’s letter to State Budget Director Robert Mujica and State Health Commissioner Howard Zucker.

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July 2, 2019

Robert Mujica, DirectorNew York State Division of the Budget State Capitol Building Albany, NY 12210

In anticipation of federal actions that would eviscerate the Title X Family Planning Program, the Legislature and the Governor included language in the 2019 budget legislation that authorizes the State to make up for the lost federal funding if it became necessary.

Together, we believe that patient health must come first. With the new federal rule in effect, Title X provider may not even discuss with patients the full range of reproductive health care options, including abortion. Proper professional care cannot be delivered if health care providers comply with the new Title X restrictions. New York must now keep its commitment and use the funds budgeted to fill the Title X gap.

Under the budget language, $16 million “may be available upon a determination by the budget director, in consultation with the commissioner of health to provide financial assistance to health care providers in circumstances where the use of Federal monies is prohibited based on the core mission of those providers.”

I urge you to make that determination immediately and provide that financial assistance.

The New York City Health+Hospitals Corporation has announced that it will refuse the federal dollars in order to keep providing patients with the same standard of care. It is likely that other providers who rely on Title X funding will similarly turn down the federal dollars because of the harmful restrictions it now imposes.

“For services and expenses, including grants, related to emergency assistance distributions as designated by the commissioner of health. Notwithstanding section 112 or 163 of the state finance law or any other contrary provision of law, such distributions shall be limited to providers or programs where, as determined by the commissioner of health, emergency assistance is vital to protect the life or safety of patients, to ensure the retention of facility caregivers or other staff, or in instances where health facility operations are jeopardized, or where the public health is jeopardized or other emergency situations exist, and up to $16,000,000 may be available upon a determination by the budget director, in consultation with the commissioner of health to provide financial assistance to health care providers in circumstances where the use of Federal monies is prohibited based on the core mission of those providers (29874) ………………………………. 18,900,000″

I urge you to make this determination immediately and provide the financial assistance to prevent irreparable disruption in the health care of the thousands of New Yorkers who rely on comprehensive services from Title X providers.

Single-payer health care may be one of the biggest debates in Albany in 2019, but it’s just one of a number of high-profile issues dealing with medical matters. Here are summaries of several health care issues expected to be at the top of the agenda.

✓ Reproductive Health Act

Although the Reproductive Health Act has passed in the Assembly the past two years, it has yet to come up for a vote in the state Senate. A priority for many Democrats in the chamber – and, importantly, for Gov. Andrew Cuomo, who said he wants it done in January – the bill would update the state’s abortion laws and codify federal protections into state law. Although abortion rights are guaranteed under the landmark Roe v. Wade U.S. Supreme Court decision, the laws on the books in New York were passed in 1970, three years before that decision. Although the state’s laws were considered progressive at the time, they have not been updated since. Democrats have argued that if a bloc of conservative judges on the Supreme Court overturned Roe v. Wade, abortion rights in the state would revert back to those passed in 1970. State Sen. Gustavo Rivera told City & State that he hopes the legislation will be addressed early in the upcoming session now that it has the votes to pass. “I would be willing to move that very quickly because I believe that it is very important, particularly with what’s happening on the national level,” said Rivera, who is likely to be named chairman of the state Senate Committee on Health.

✓ Single-payer health care

Perhaps the most expansive and expensive item on Democratic lawmakers’ agenda – and among the most controversial – is the New York Health Act, which would establish a single-payer health care system in the state and is estimated to cost $139 billion in 2022. Many incoming lawmakers campaigned on the promise that they would get it done, but even if it does pass, massive changes likely won’t happen right away. A single-payer system means that a single entity covers the cost of all health care, which is still delivered by private or nonprofit providers. Everyone pays into a single plan run by the government, which in turn is the only provider of coverage paying claims. Assemblyman Richard Gottfried’s bill has proposed one public option and a ban on the sale of private insurance unless it offers additional coverage not included in the state plan. One major obstacle the New York Health Act must overcome is a less than enthusiastic governor. Although Gov. Andrew Cuomo has expressed support for single-payer health care as a concept, he has repeatedly said that it would be better implemented at the national level. Other critics have raised concerns about the cost, although a study performed by the Rand Corp. that found total health care spending could be lower under the New York Health Act than if the status quo were to continue.

✓ Recreational and medical marijuana

The state has been slowly inching closer to legalizing recreational marijuana. Most notably, Gov. Andrew Cuomo has been coming around on the issue. Although he used to consider marijuana a “gateway drug,” the Cuomo administration this year released a report in favor of legalization, set up a working group to draft legislation and hosted a series of listening sessions across that state to gain public input. Although legislation to legalize the drug has never passed either chamber, public support has grown substantially, and candidates, such as former gubernatorial candidate Cynthia Nixon, campaigned on the promise of legalization. The state Legislature now appears poised to pass legislation that would regulate and tax marijuana.

However, the future of the state’s existing medical marijuana program remains in limbo. Assemblyman Richard Gottfried, who sponsored the bill creating the medical marijuana program and has been one of its strongest advocates, said that in the coming session, strengthening and expanding the program will be “a major focus,” as will ensuring that it continues to run smoothly alongside potential recreational legalization. “So how we do that, I don’t know yet. But I know there is a lot of concern and brainpower being focused on it,” Gottfried told City & State. State Sen. Gustavo Rivera said he hopes that recreational legalization would also open the door for additional research to increase and expand the drug’s medical efficacy.

✓​​​​​​​ Opioid epidemic

As the opioid epidemic continues to take lives across the state, state Sen. Gustavo Rivera told City & State that the state Senate intends to resume its work with the Task Force on Heroin and Opioid Addiction – first created in 2014 – and that state Senate Republicans could participate as well. When led by Republicans, the task force did not include Democrats. Additionally, Rivera said that the state Legislature will continue to explore the concept of harm reduction. The idea accepts that drug use will always be a part of society, but that society can take steps to cut down on the negative consequences of drugs. Namely, Rivera hopes to have productive conversations about a bill he sponsors to create safe injection sites, a highly controversial proposal to create legal locations where illegal drug users can get high in a supervised environment. “I believe that there is plenty of evidence-based programs that can be expanded and be created,” Rivera said. New York City Mayor Bill de Blasio championed a pilot program to open four such sites in the city, but the idea still faces major hurdles.

✓​​​​​​​​​​​​​​ Nurse staffing ratios

The issue of nurse staffing levels within hospitals has long been a priority of the New York State Nurses Association, a powerful union in the state. However, a bill on the subject has never passed the state Senate and rarely passes the Assembly. The main component of the bill would create a set ratio of patients per nurse to ensure that nurses are not overworked by caring for too many people, and to ensure that patients are receiving adequate care. However, other powerful interests have also opposed the legislation, including business groups and hospitals, who argue that while the bill addresses real problems with how care is administered, nurse staffing ratios are the wrong remedy. Like many pieces of legislation that have languished under Republican control of the state Senate, Democratic control of the chamber could give the bill a better chance to become law. “We’ve passed it before and I trust we will do it again,” said Assemblyman Richard Gottfried, who has long been a supporter of nurse staffing ratios. “And it’s very exciting that we now have a shot at having that pass the state Senate.”

Thanks to a flu season that’s one of the worst in recent memory, it has been a tough winter to stay healthy. Influenza hospitalizations are up and thousands have died. The flu vaccine has proven to be less effective than in years past, and public health experts say the disease may have yet to reach its peak. The spread of the virus is likely to continue for weeks.

It has also been a tough winter for New York policymakers and government officials who rely on Washington for funding. While congressional Republicans failed to repeal the Affordable Care Act, they’ve taken incremental steps to undermine the law, such as eliminating the individual mandate. The federal government has also reduced funding for safety net hospitals and for the ACA’s Basic Health Program, both of which play a major role in New York. Some Republicans in Washington still hope to scale back Medicaid and Medicare as well.

So we checked in with a few of New York’s top health care officials to hear their diagnosis of the situation – and how to remedy it.

Members, supporters and advocates for the New York Civil Liberties Union rallied Monday outside the Capitol in support of several bills they say would protect and expand civil rights. Public defense funding and reform, reproductive rights, transgender discrimination, electronic privacy, and police data transparency were all on the agenda for the group’s day of action.

Speakers Jonathan Gradess, executive director of the New York State Defenders Association, and Darren Mack, a former inmate at Rikers Island prison, advocated for the Justice Equality Act (A.1903), sponsored by Assemblywoman Patricia Fahy, D-Albany.

SYRACUSE, N.Y. – The U.S. abortion rate has hit a historic low as a clash looms between President-elect Donald Trump, who has vowed to outlaw abortion, and abortion rights advocates, many of whom will join the Women’s March on Washington Saturday.

For the first time since 1975, the number of abortions in the U.S. dropped below 1 million in 2013 and 2014, according to a report put out this week by the Guttmacher Institute, a reproductive research group in New York City.

The report shows there were 926,200 abortions in 2014, or 14.6 abortions per 1,000 women, down 14 percent since 2011.

Today, the Assembly Health Committee reported and the Assembly overwhelmingly passed the Reproductive Health Act (RHA), A.1748, introduced by Assembly Member Deborah Glick. The RHA eliminates outdated language in New York State law; guarantees a woman’s right to choose; and ensures constitutionally protected access to safe, legal abortion. It also takes New York’s abortion law out of the Penal Law and puts it in the Public Health Law where it belongs. Reproductive freedom is fundamental and must be secured.

The U.S. Supreme Court will very likely soon have a majority of judges who oppose protecting reproductive choice. This, and Republican control of Congress and the White House, makes it more important than ever for New York to pass the Reproductive Health Act.

As chair of the Assembly Health Committee, a founding member of the New York State Bipartisan Pro-Choice Legislative Caucus, and someone who has been active with NARAL since 1969, protecting and strengthening reproductive rights and access to care are among my highest priorities. New York’s own landmark law on abortion – enacted three years before Roe v. Wade decision – provides most, but not all, the protections of Roe.

The RHA adds a provision to the Public Health Law saying that any appropriately licensed health care practitioner such as a physician assistant, nurse practitioner, or professional midwife may perform an abortion up to 24 weeks of pregnancy, or if there is an absence of fetal viability, or if the abortion is necessary to protect the life or health of the woman. In contrast, the current abortion provision in the state Penal Law says only a physician may perform an abortion and only allows an abortion after 24 weeks when necessary to protect the life of the woman. The RHA would strengthen New York’s law to fully cover all the provisions of the Roe v. Wade decision, and all applicable laws and regulations governing health care in New York will also apply.

While we in New York have been working to protect women’s health, state legislatures and governors across the country have been working to pass unconstitutional anti-choice bills. New York is a pro-choice state – with a history of pro-choice governors, legislators and other elected officials – because we have so many active pro-choice advocates. As Washington threatens reproductive health care rights and access, it is more critical than ever that we organize and fight to protect every woman’s reproductive rights.

A state legislative proposal requiring health insurers in New York to cover contraception without co-payments, now mandated by Obamacare, has been reintroduced by Attorney General Eric Schneiderman as Republicans in Congress seek to undo the federal law.

Also Wednesday, in Washington U.S. Sen. Kirsten Gillibrand, a Democrat, urged federal lawmakers to keep the no-cost contraceptive provisions of the law, formally the Affordable Care Act, along with access to mammograms and cervical cancer screenings. Gillibrand has filed an amendment to the federal 2017 budget that would retain these parts of the law.

The election of Donald Trump and Republican control of Congress are a serious threat to programs and policies that protect our health. Washington could make radical changes to Medicare, Medicaid, the Affordable Care Act, reproductive care, and other programs that could drastically undermine our right to health care, cost New York State billions of dollars a year in federal funds, and destabilize health care providers.

The first step in stopping or reversing these attacks is to clearly understand what’s at stake and spread the word. There is hardly anything more rigged against working people than health care. The Trump-Republican agenda will make it worse. This is a time to redouble efforts in more progressive states like New York to create universal access to health care, with funding based fairly on ability to pay, through an “improved Medicare for all” system.

For years, congressional attacks on funding and programs have been defeated by the threat or use of presidential vetoes. Now we will have a president who may be leading the charge.

“Yesterday’s U.S. Supreme Court decision striking down Texas’s anti-choice law restricting access to abortion – in the sheep’s clothing of “safety” regulations –was an extraordinary victory for reproductive rights, patient autonomy, and the right to health care with regulations based on science rather than politics.

Texas is just one of many states engaging in right-wing attacks on reproductive health care. We must fight back against these attempts to politicize crucial health care services. Pro-choice supporters have a lot of work to do.

New York has long been a leader in protecting reproductive freedom. Our landmark protection of abortion enacted in 1970 helped provide the framework for the Roe v. Wade decision three years later, but we have our own battle here. The Assembly has passed the Reproductive Health Act to strengthen our law. But the State Senate did not pass it, reflecting the threat that reproductive freedom faces around the country.

Before yesterday’s decision was released, there was real fear that the decision could go the other way and open the door to horrendous state and federal restrictions on reproductive care. Yesterday’s victory should be a reminder that the U.S. Supreme Court could easily be turned in that direction by even one or two presidential appointments to the Court.

As Chair of the Assembly Health Committee, a key part of my job has always been – and will continue to be – to defend reproductive rights, patient autonomy, access to health care, and policies based on good science and public health principles. Our work together is not done.”

WELCOME!

I represent Chelsea, Hell’s Kitchen, Midtown, and parts of Murray Hill and the Lincoln Center area in the State Assembly. I have been chair of the Assembly Health Committee since 1987. During off hours, I like to write Chinese calligraphy.